目的 探讨白蛋白-胆红素(ALBI)联合中性粒细胞与淋巴细胞比值(NLR)预测肝硬化合并食管胃底静脉曲张破裂出血(EGVB)的临床价值。方法 回顾性分析2021年1月—2022年12月肇庆市第一人民医院消化内科收治的80例肝硬化合并EGVB患者的临床资料,通过电话及门诊、再入院对其进行为期1年的随访,根据随访结果,将其分为2组,即存活组(n=69)与死亡组(n=11),分析导致患者死亡的危险因素,并评估ALBI联合NLR预测肝硬化合并EGVB患者死亡的临床价值。结果 死亡组的年龄60岁以上、腹水和肝性脑病者占比,总胆红素(TBiL)、NLR、凝血酶原时间(PT)、谷丙转氨酶(ALT)水平及ALBI评分均高于存活组(均P<0.05),而血红蛋白(HGB)、白蛋白(ALB)及血钠水平均低于存活组(均P<0.05);Logtisic回归分析显示,年龄60岁以上、腹水、肝性脑病和TBiL、NLR水平升高及ALBI分级为3级是肝硬化合并EGVB患者死亡的危险因素(均P<0.05);ALBI联合NLR预测肝硬化合并EGVB患者预后的准确率及灵敏度高于单一诊断,漏诊率低于单一诊断(P<0.05)。结论 肝硬化合并EGVB患者可见ALBI评分及NLR水平升高,而以上两种指标是患者死亡的危险因素,将其联合检测可评估患者预后,预测其死亡风险。
Objective To investigate the clinical value of albumin-bilirubin(ALBI)combined with neutrophil lymphocyte ratio(NLR)in predicting liver cirrhosis complicated with esophageal and gastric varices bleeding(EGVB).Methods The clinical data of 80 patients with liver cirrhosis complicated with EGVB admitted to the Department of Gastroenterology of the First People’s Hospital of Zhaoqing from January 2021 to December 2022 were retrospectively analyzed.They were followed up for one year by telephone,outpatient service and readmission.According to the follow-up results,they were divided into the survival group(n=69)and the death group(n=11).The risk factors leading to the death of patients were analyzed and evaluated.Results The proportion of age over 60,ascites and hepatic encephalopathy,the levels of TBiL,NLR,PT,ALT and ALBI in the death group were higher(P<0.05),while the levels of HGB,ALB and blood sodium were lower(P<0.05).Logistics analysis showed that age over 60,ascites,hepatic encephalopathy,NLR and ALBI grade 3 were independent risk factors for the death(P<0.05).The accuracy and sensitivity of ALBI combined with NLR in predicting their prognosis were significantly higher than that of single diagnosis,and the missed diagnosis rate was lower(P<0.05).Conclusions ALBI scores and NLR levels significantly increase in patients with liver cirrhosis complicated with EGVB,and the above two indexes are risk factors for the death,and the combination of them can evaluate the prognosis of patients and predict the death risk.
目的 分析谷草转氨酶(AST)、胆碱酯酶(CHE)、糖类抗原125(CA125)以及甲胎蛋白(AFP)对肝硬化患者的诊断效能。方法 选择70例肝硬化患者为观察组研究对象,另取70例同期健康体检者为对照组。两组研究对象均接受生化检验、肿瘤标志物检验。对比两组研究对象的AST、CHE、CA125、AFP检测结果,分析上述指标对肝硬化患者的诊断效能。结果 观察组肝硬化患者的CHE低于对照组,AST、CA125与AFP高于对照组(P<0.05);AST与CHE在肝硬化诊断中具有良好的灵敏度、特异度;CA125联合AFP的灵敏度、特异度、符合率均高于CA125或AFP单独检验(P<0.05)。结论 AST、CHE、CA125、AFP在肝硬化患者临床诊断中具有良好的应用表现,是反映患者肝硬化病情进展的重要参考指标。
Objective To analyze the diagnostic efficacy of aspartate aminotransferase(AST),cholinesterase(CHE),carbohydrate antigen 125(CA125),and alpha fetoprotein(AFP)in patients with liver cirrhosis.Methods A total of 70 patients with liver cirrhosis were included in the observation group as the study subjects,and 70 healthy individuals who underwent physical examinations during the same period were selected as the control group.Both groups of research subjects underwent biochemical testing and tumor marker testing.The AST,CHE,CA125,and AFP detection results of two groups of research subjects were compared,and the diagnostic effect of the above indicators on patients with liver cirrhosis were analyzed.Results The CHE test results of patients with liver cirrhosis in the observation group were significantly lower than those of healthy individuals undergoing physical examination,and the AST,CA125,and AFP test results were higher(P<0.05).AST and CHE had good sensitivity and specificity in the diagnosis of liver cirrhosis.The sensitivity,specificity and coincidence rate of CA125 combined with AFP were higher than those of CA125 or AFP alone.Conclusions AST,CHE,CA125,and AFP have good clinical application performance in the diagnosis of liver cirrhosis patients,and are important reference indicators reflecting the progression of liver cirrhosis in patients.